Maybe, but take it from me, you wouldn't like the consequences. Losing a lung is no fun, it is reputably the most painful surgery there is, and the long term effects are no fun either, not just the lack of puff, but the extra strain on the heart from losing part of its shock absorbing protection too. Yet you're grateful for having to endure it all because surgery is the only potential cure. Most lung cancers are too advanced for surgery by the time they're discovered.

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one more question Ian, i know she knows my med cocktail and put me on trazodone for when i have difficulty sleeping...but i read about trazodone interactions with prozac and klonopin! apparently trazodone + prozac can cause serotonin syndrome?

Trazodone only begins to affect serotonin at doses above 150-225mg so there is no danger of serotonin syndrome at 25mg, or even 125mg.

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and i don't want to stop breathing in my sleep because the trazodone depresses my CNS on top of the klonopin.

No, trazodone isn't have the impact of alcohol on the brainstem. Interestingly, trazodone and the amino acid and serotonin precursor L-Tryptophan (L-T) reduces breathing difficulties in in British bulldogs which are notorious for having breathing problems and I can't see why this wouldn't apply to humans too with Prozac replacing the L-T. Note: don't be tempted to take L-T as there would be a definite danger of serotonin syndrome by combining it with Prozac, plus if that syndrome doesn't get you, Eosinophilia-Myalgia Syndrome might.

HOWEVER, taking trazodone and Klonopin together may enhance the sedation greatly, so caution is necessary. You could end up sleeping through much of the next day. Be extra cautious when operating machinery, or engaging in potentially hazardous activity as judgment may be impaired.

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i think tomorrow night i'm gonna take the whole pill, 50mg

See the caution above, plus be aware that double the dose doesn't necessarily mean double the sedation. The effect diminishes as the dose increases until there is little at 300mg plus.

Ian

thanks for all the helpful advice Ian, as usual I'm glad I don't have to worry about serotonin syndrome, and here I am the next morning feeling ok. Klonopin really doesn't make me feel tired at all anymore, so the increased sedation shouldn't apply right? That's disappointing that double the dose does mean double the sedation...because I hardly felt anything last night! at most I felt a little drowsy. And I'm not going to be taking trazodone daily, only as needed so hopefully I don't build a tolerance to the sedation

NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Darn, after all the trouble I went to getting a 24 hour life insurance policy on you.

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I'm not going to be taking trazodone daily, only as needed so hopefully I don't build a tolerance to the sedation

Tolerance isn't usually a problem.

Ian

LMFAO! and that's great news, let's see if this 50mg will work! just took it. i'm also not too sure about calling my psych doc and upping my prozac dose so soon...i feel like i'm still getting increased anxiety. would prozac side effects last a bit longer since it takes soooo long to stabilize in your body? or no? because when i used to take klonopin as needed it worked like a charm. now when i take it i feel like it does about....70% of its job compared to what it used to do? i know that's still pretty good but i mean....i don't know. what do you have to say about this Ian?

i'm also not too sure about calling my psych doc and upping my prozac dose so soon...i feel like i'm still getting increased anxiety. would prozac side effects last a bit longer since it takes soooo long to stabilize in your body? or no?

Possibly. Either way, I don't think there is anything to be gained by delaying the increase. The jump in anxiety probably won't be any worse than if you wait for the current level to drop, which may take several weeks, maybe even longer. The sooner you get onto a therapeutic dose the sooner this all starts to resolve.

That's the relatively good news, the really, really bad is I can't afford to insure you for another 24 hours, so if you drop off the perch tonight I won't be filthy rich. Life can be so cruel!

NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

i'm also not too sure about calling my psych doc and upping my prozac dose so soon...i feel like i'm still getting increased anxiety. would prozac side effects last a bit longer since it takes soooo long to stabilize in your body? or no?

Possibly. Either way, I don't think there is anything to be gained by delaying the increase. The jump in anxiety probably won't be any worse than if you wait for the current level to drop, which may take several weeks, maybe even longer. The sooner you get onto a therapeutic dose the sooner this all starts to resolve.

That's the relatively good news, the really, really bad is I can't afford to insure you for another 24 hours, so if you drop off the perch tonight I won't be filthy rich. Life can be so cruel!

Ian

yeah, i suppose you're right. it's just scary messing with all these doses and side effects i'm so thankful that no antidepressant has caused me the infamous ssri sexual dysfunction, lmao! that would be a huge PITA.

yes it seems like you'll be getting no money, since i survived another night the 50mg trazodone definitely made me sleepy, in an oddly calm and gentle way. i was expecting it to knock me out. it took so long to starting working though which was annoying. and also it gives me really bad dry mouth nothing a little extra water can't fix though. i'll be back in 10 days, after i see my psych doc. i'm curious what will happen!

Hello everyone! I hope everyone had a good new year. I am back with updates: my prozac was raised to 20mg, and my trazodone was raised from 50mg to 75mg/100mg. right now I've been taking 75mg and it's working better, but I feel like 100mg will be the sweet spot. Just nervous to up it so fast I've been on prozac 20mg for what is now the 5th day, and the same side effects I had in the beginning started around the same day, day 3. decreased appetite, free floating anxiety / tension. hope this goes away soon but I'm glad I'm on a therapeutic dose now. Still taking klonopin .5mg twice a day, though I have had to take an extra half klonopin last night since the tension was really bad. overall things are going good, even with the few side effects I'm experiencing right now. I feel really hopeful about this drug cocktail. two of my problems have been reduced a ton, my insomnia and anxiety/panic/agoraphobia. Now to just knock out the depression, which is not as bad as it used to be. I'm also hoping the increased prozac will help with any of the residual anxiety I've had. I'll give everyone an other update in possibly a week. I hope everyone is doing well.

my trazodone was raised from 50mg to 75mg/100mg. right now I've been taking 75mg and it's working better, but I feel like 100mg will be the sweet spot. Just nervous to up it so fast

The worst thing that could happen is you sleep away much of the next morning.

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I feel really hopeful about this drug cocktail. two of my problems have been reduced a ton, my insomnia and anxiety/panic/agoraphobia. Now to just knock out the depression, which is not as bad as it used to be.

The SSRIs tend to be a little better at resolving anxiety than depression. Not sure why this is given both disorders are driven by the same biology, but it does seem to be the case.

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yes it seems like you'll be getting no money, since i survived another night

How am I ever going to get the money I need to achieve my dreams of world conquest if you guys won't drop of the perch while I'm insuring your lives? Sigh! Some people are so inconsiderate!! humph

NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Hi Ian, I have a few questions that I'd really appreciate if you could answer them. So over the weekend I caught the flu and I've been recovering, and I feel much better then when it first hit me. I have one concern though. First, I noticed my depression and anxiety has heightened a bit since getting sick. is it normal for colds/flus to aggravate things like this? Second, I've noticed a big decrease in appetite and feeling very nauseous. I almost threw up today. I am not sure if it is the prozac....the flu....or something else I'm paranoid about......acetaminophen toxicity I'm not sure what the name brand for acetaminophen is in your country, but I have been taking the maximum daily dosage every day since I've gotten sick. I think I may have took an extra 1000mg one day. I looked up that within 12 hours you start to feel nauseous and start vomiting, and then you feel fine and then your liver starts to shut down. Do you think I'm okay in that department? I think I might be paranoid but I don't know. It really sucks and I have no idea how to get rid of the nausea other than ginger tea, which temporarily relieves it.

First, I noticed my depression and anxiety has heightened a bit since getting sick. is it normal for colds/flus to aggravate things like this?

Sure. In many respects stress and its consequences, including anxiety and depression, are immune system disorders, and also negatively inpact the immune system. See, for example: Miller AH, 2011 (see also); Leonard BE, 2010. Immune system boosting drugs such as the interferons used to treat cancers often trigger mood disorders, so much so that antidepressants are now routinely given together with these drugs. In addition to their anti anxiety/depression effects, most antidepressants are also reasonably powerful anti inflammatory drugs which may account in part for their effectiveness.

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or something else I'm paranoid about......acetaminophen toxicity I'm not sure what the name brand for acetaminophen is in your country,

Acetaminophen is mostly use in North America. To the rest of the world it's paracetamol with the leading brand being Panadol.

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but I have been taking the maximum daily dosage every day since I've gotten sick. I think I may have took an extra 1000mg one day. I looked up that within 12 hours you start to feel nauseous and start vomiting, and then you feel fine and then your liver starts to shut down. Do you think I'm okay in that department? I think I might be paranoid but I don't know. It really sucks and I have no idea how to get rid of the nausea other than ginger tea, which temporarily relieves it.

The suggested maximum daily dose is 4,000mg, typically taken as 2x500mg x 4 times a day. I doubt an extra one off 1,000mg will do harm. If you're concerned then you can take it with N-Acetyl Cystein (NAC) supplements. NAC is used in ERs to protect the liver in overdose cases. In some countries paracetamol and NAC are combined in the one tablet. I have no idea of what dose may be effective, but I take about 1,000mg of NAC daily to reduce fluid buildup in my lung and so far it hasn't done me any harm, unlike the med i was prescribed for this which had me gasping for breath. There is also some evidence that NAC may enhance the effectiveness of antidepressants for OCD.

NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

First, I noticed my depression and anxiety has heightened a bit since getting sick. is it normal for colds/flus to aggravate things like this?

Sure. In many respects stress and its consequences, including anxiety and depression, are immune system disorders, and also negatively inpact the immune system. See, for example: Miller AH, 2011 (see also); Leonard BE, 2010. Immune system boosting drugs such as the interferons used to treat cancers often trigger mood disorders, so much so that antidepressants are now routinely given together with these drugs. In addition to their anti anxiety/depression effects, most antidepressants are also reasonably powerful anti inflammatory drugs which may account in part for their effectiveness.

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or something else I'm paranoid about......acetaminophen toxicity I'm not sure what the name brand for acetaminophen is in your country,

Acetaminophen is mostly use in North America. To the rest of the world it's paracetamol with the leading brand being Panadol.

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but I have been taking the maximum daily dosage every day since I've gotten sick. I think I may have took an extra 1000mg one day. I looked up that within 12 hours you start to feel nauseous and start vomiting, and then you feel fine and then your liver starts to shut down. Do you think I'm okay in that department? I think I might be paranoid but I don't know. It really sucks and I have no idea how to get rid of the nausea other than ginger tea, which temporarily relieves it.

The suggested maximum daily dose is 4,000mg, typically taken as 2x500mg x 4 times a day. I doubt an extra one off 1,000mg will do harm. If you're concerned then you can take it with N-Acetyl Cystein (NAC) supplements. NAC is used in ERs to protect the liver in overdose cases. In some countries paracetamol and NAC are combined in the one tablet. I have no idea of what dose may be effective, but I take about 1,000mg of NAC daily to reduce fluid buildup in my lung and so far it hasn't done me any harm, unlike the med i was prescribed for this which had me gasping for breath. There is also some evidence that NAC may enhance the effectiveness of antidepressants for OCD.

Ian

oh wow.....that is very interesting. thanks so much again for the help Ian, you are honestly so helpful to complete strangers. I am definitely not paranoid anymore, and I think I'm just nauseous because I'm sick. oh well. also very interesting that acetaminophen is paracetamol, I thought that was just a name brand like Tylenol in the US. Guess not! One thing I know for sure is that after getting the flu 2 years in a row...I am DEFINITELY going to get a flu shot next year. Can't handle all this crap! thanks again for calming my nerves Ian

One thing I know for sure is that after getting the flu 2 years in a row...I am DEFINITELY going to get a flu shot next year.

Good idea. I have an overactive immune system so rarely get the flu, etc. The last time was 26 years ago while in hospital after developing PD. Terrible places hospitals, full of sick people coughing and spluttering. :)

However, since I was reduced to one lung my doctor has insisted I get a shot every year anyway which would be okay except he's hopeless at injecting, he holds the syringe like a dagger and plunges it in like he means to take my arm off so I now insist the nurse does it, or if she's not available, I do the deed myself.

Ian

PS: I was wrong about NAC being added to some paracetamol formulations to prevent hepatotoxicity. They actually add the amino acid methionine, which is a cysteine precursor. But NAC is definitely the antidote used in ERs, usually administered intravenously.

NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Hi everyone! Here to update you all on my recovery. The med cocktail I'm on right now is 20mg prozac, klonopin .5mg x2 a day, and trazodone 100mg at night. and let me tell you, i feel completely different than I did a year ago. It is amazing how I feel, it's just I feel so...normal? I would not consider myself agoraphobic anymore, and I would say my anxiety levels are extremely low, just normal anxiety levels that most people have. No constant worrying, no fear of leaving my house because something bad will happen, no more obsessing over my blood sugar, it's all gone. I feel like my true old self. Social, talkative, engaging, excited, interested in life. My depression has almost disappeared, but it still lingers, though I have only been on the therapeutic dose of prozac for 4 weeks, so I am sure it will get even better. But I know it's different because when I wake up in the morning, I actually feel AWAKE and I am in a good/pleasant mood, looking forward to the day! Even my biggest triggers, which is when I am home alone all day, I feel fine. I don't feel sad, alone, suicidal, I simply feel bored in those situations now. Still do have my crying episodes, but I am pretty emotional is there is still stress in my life. And the trazodone, while admittedly not so amazing, it helps me to unwind so much at night and actually sleep and stay asleep through the night. It does take a while to kick in for me, 2 hours, but when it does I feel sedated in a way different from benzos, or antihistamines. It is just a calm gentle sleepiness, and I am ready for bed. No anxiety or depression during bedtime that kept me up all night. Overall, I would say I am about 85-90% recovered, or in remission you could say. I was so happy that I went to a psychiatrist who was understanding and gentle with me. To sum it up: meds have increased my quality of life greatly, from having 0 quality of life to actually feeling good, normal. I will still keep you all up to date in case anything happens, but I am going to start working on my life now that I am able to. Also going to see a counselor. I hope everyone finds the peace that I am just beginning to find. Good luck to everyone out there.

Hi everyone! Here to update you all on my recovery. The med cocktail I'm on right now is 20mg prozac, klonopin .5mg x2 a day, and trazodone 100mg at night. and let me tell you, i feel completely different than I did a year ago. It is amazing how I feel, it's just I feel so...normal?

I'm glad it is working for you. :happy0151:You've only been on Prozac for a few weeks so there should still be improvement to come.

NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

I have no idea of what dose may be effective, but I take about 1,000mg of NAC daily to reduce fluid buildup in my lung and so far it hasn't done me any harm, unlike the med i was prescribed for this which had me gasping for breath. There is also some evidence that NAC may enhance the effectiveness of antidepressants for OCD.

Since I wrote this I've become aware of a new study which finds that NAC (and also vitamin E) should not be taken by anyone at risk of lung cancer, i.e. smokers and those with some types of lung disease. (Study abstract)

Furthermore, if the authors are correct in believing that antioxidants increase cancer risk by making it harder for the immune system to find and destroy cancerous cells then all such supplements may be suspect. This isn't the first study to find that taking concentrated antioxidants can be risky. A few years ago two large-scale studies testing the effectiveness of beta-carotene in preventing lung cancer had to be aborted when it became clear that the supplements were actually causing far more cancers. The safest way of boosting antioxidants levels may be by eating the foods that contain them, not with supplements. These contain other compounds, few of which we know much about, which may moderate the harmful effects while boosting the beneficial ones.

NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.